Ann Vasc Surg 2019 Apr 19. Epub 2019 Apr 19.
Specialist, Emergency Medicine Clinic, Kayseri Training and Research Hospital, Kayseri, Turkey. Electronic address:
The Splenic infarct is a rare clinical condition seen in the emergency department and can mimic acute abdomen. Hematologic, vascular and thromboembolic events are considered in the etiology. Treatment options are varying between symptomatic treatment and splenectomy. Warfarin is a vitamin K antagonist used for prevention and treatment of the thromboembolic disorders. In overdose situations there is a possibility for bleeding in every part of the body. Prothrombin complex concentrates, vitamin K and fresh frozen plasma (FFP) are used in the treatment of warfarin overdose. We describe a case of splenic infarct coexistent after warfarin overdose treatment which has never been published. Prothrombin complex concentrate was administered to the patient due to warfarin overdose. A spleen infarction was detected in the computerized tomography of the patient after the descending of the abdominal pain and there wasn't any infarction three days before hospitalization. The patient was monitored with symptomatic treatment in the general surgery clinic and discharged without need for operation. In the pathogenesis it was thought that prothrombin complex concentrates might be caused by early thrombosis or by warfarin not affecting the existing clot. It was emphasized that emergency physicians should not forget the spleen infarction in the differential diagnosis of abdominal pain.